Honolulu, USA: On the remote island-state of Kosrae, a tiny dot on the extreme eastern edge of the Federated States of Micronesia, medical care for women is basic.

"They have a doctor there who looks after the women's health," said Dr. James B. MacMillan III, a retired gynaecologist and adjunct faculty member at the John A. Burns School of Medicine at the University of Hawai'i (UH), USA. "But there isn't a specialist in gynaecology or obstetrics, and there isn't any gynecological surgical care there at all."

So MacMillan and the medical school put together a team of surgeons and nurses who volunteered to help out for 10 days, and Hawaii hospitals came through with donations of medical equipment. UH helped pay for the medical team's accommodations on the 42-square-mile island (or 110,000 squared metres), and Continental Micronesia Airlines provided transportation for the team and their equipment.

"Everyone just opened up and helped out," MacMillan said.

An advance team arrived on Kosrae a week ago and began examining women.

With a diabetes rate of 40 percent for adults over the age of 35 in Micronesia, MacMillan said, the advance team — Dr. Nicholas Fogelson of the medical school and a nurse practitioner who did not want to be identified — expected to find gynaecological problems among the 8,000 residents of Kosrae. Their expectations were met.

"They've found pelvic masses, ovarian cysts, tumors and a whole host of other things," MacMillan said.

MacMillan, Dr. Reni Soon, also from the medical school, and nurses James Michael Meyer, Sharon Parson Hee and Marivic Aquino Jackson, flew out yesterday to join the advance team.

They'll attend to the women in most immediate need of surgical care. They won't get to everyone.

The advance team examined 100 women who need surgery, MacMillan said. He figures the team will be able do at least 20, possibly as many as 30 operations during their 10-day stay on Kosrae.

"They only have one operating room in the hospital," MacMillan said, "so we'll be doing one case at a time. If they have emergencies, we'll have to hold back on our cases and see if we can help them with the emergency cases."

Kosrae doesn't have a blood bank. MacMillan said that necessitates the use of what he called a walking blood bank.

"At least two people will sit outside the operating room who've been cross-matched to donate blood, if needed," he said. Kosraens are accustomed to the system, he said.

"Everyone knows if you need surgery, you've got to have two family members cross-matched to give blood," he said. "It's fresh, whole blood with all the clotting factors and it works fine."

MacMillan said the team hopes to return to Kosrae after the mission is over.

"If we're invited back we'll probably go once a year for at least five years," he said, "because there is at least that much of a backlog of surgeries to do."